In Britain, community backlash to compulsory vaccination was almost immediate following the implementation of The Vaccination Act. They viewed this government directive as a personal assault by the ruling class on working class Britain. Communities at this time valued their individual rights, perhaps more so then we do today, to such an extent that riots occurred in many towns and in the same year the Anti-Vaccination League in London was formed. The US also saw the uprising of this external element fanning the flames of controversy with the formation of the Anti-Vaccination Society of America in 1897, The New England Anti-Compulsory Vaccination League in 1882, and the Anti-Vaccination League of New York City in 1885.

Not surprisingly, due to the extensive vaccination program, the incidence of smallpox outbreaks was greatly reduced. Anti-vaccination lobbyists would proclaim however to be as a result of greater education in public health and improvement in sanitation, which almost certainly had an impact.

By 1885 a royal commission was initiated in Britain to examine the claims of the anti-vaccination groups. It took seven years of listening to both sides of the vaccination debate before a new Vaccination Act was initiated in 1898 which gave parents the right to refuse vaccination for their child based on efficacious and safety reasons.